The teen years are hard enough. But with today's increased pressures to produce at school, stay in step with being cool, and manage a jam-packed schedule, it's no wonder many teens are overwhelmed. The result is a generation experiencing greater stress and feeling more depressed than any other. 

This book will inspire and equip parents to help their hurting teens. The well-known and widely respected author team of Dr. Catherine Hart Weber and Dr. Arch Hart help parents discover and identify nervousness, irritability, negativity, and low self-esteem, and determine whether their teen's symptoms are caused by physical problems, raging hormones, stress, or depression. Offering practical suggestions, spiritual solutions, and encouragement, this resource helps parents and teens face their own feelings of fear, anger, and hurt.

Is Your Teen Stressed or Depressed? will help parents determine whether their child is simply acting like a hormone-raging teenager, or is actually suffereing from too much stress or even depression.

IS YOUR TEEN STRESSED or DEPRESSED?

A Practical and Inspirational Guide for Parents of Hurting TeensBy Archibald D. Hart Catherine Hart Weber

Thomas Nelson

Copyright © 2008 Dr. Archibald D. Hart and Dr. Catherine Hart Weber
All right reserved.
ISBN: 978-0-7852-8940-1

Contents

Foreword........................................................................................xiPart I: Hearing Hurting Teens1. Understanding Your Teen's World..............................................................3Hope for Hurting TeensTurbulent Times for Troubled TeensWho Suffers?Finding Hope and Practical HelpSafe-Place Parenting for Hurting Teens2. What Is Normal and What Is Not: A Healthy Journey Through the Teen Years.....................23A Time of TransitionPersonal Development of a TeenThe Developing BrainAn Entryway for Stress3. Taming Teenage Stress Hormones...............................................................38When Stress Turns BadWhen Stress Is Intense and ProlongedWhat Is Stress, and What Does It Do?Why Are Teens So Stressed Out?The Stress, Depression, and Anxiety LinkEvaluating Your Teen's Stress LevelHow Does Your Teen Deal with Stress?How Parents Can Help Their Teen De-Stress4. Beating Back Teen Depression.................................................................64A Basic Understanding of DepressionTreat the Depression, Not Just the SymptomsWhat Is Depression?What Type of Depression Is It?Determining the Source of DepressionDiagnostic Categories of DepressionWhat Causes Depression?Treatment Depends on the Type and Cause of DepressionWhat Does Teen Depression Look Like?Is It Normal, or Is It Depression?Getting Help for Your Teen5. More Than Depression: Deadly Teen Issues.....................................................89What Are the Major Anxiety Disorders of Adolescence?Substance AbuseSelf-Medication Through Alcohol and Drug AbuseGeneration RxThe Problem: Teens Don't Get Help Early EnoughWhat Can Reduce Substance Abuse?Sexual Abuse and AssaultOvercoming Sexual AbuseWhat to Do If Your Teen Has Been Sexually AssaultedSelf-Injury and CuttingSuicidePart II: Getting Help To Get Better6. Finding the Right Counselor..................................................................113How Is Teenage Depression Commonly Treated?First Things FirstWhen to Consider CounselingCounseling Provides Healing Through Talking and ListeningTypes of CounselingTypes of Therapy Pursuing Counseling Help for Your TeenWhat Can You Expect from a Counselor?Finding a Therapist for Your TeenWhat to Say During Your Initial CallEvaluating the Counselor and the TherapyUnderstanding the Therapeutic ProcessCrisis FirstKnowing When to Let GoTreatment GoalsHow Long Will Treatment Last?What If the Therapy Interventions Aren't Working?Get the Help Your Teen Needs7. Sensible Management of Medication............................................................137Parents Must Stay InformedStart with a Medical EvaluationConsider CounselingHow Do Antidepressants Work?Antidepressants Take Time to WorkMaximum Dose for Maximum ResultsCommon Fears About Antidepressant MedicationTypes of Antidepressant MedicationsSide EffectsQuestions to AskWhat About Integrative and Herbal Medicines?Getting Well Takes More Than a Pill a Day8. Getting Better and Staying Well..............................................................153Strategies for Living WellBuilding a Wellness Action PlanPrevention and Restoration9. Bounce-Back Adaptability.....................................................................172Resilient LivingLearning Resilient LivingThe Resilient-Living Journey10. Teaching Healthy Ways of Thinking...........................................................189Winning the Battle of the MindNegative Self-Talk versus Reality TalkThe Dirty Dozen DistortionsAccentuate Accurate ThinkingAttitude AdjustmentChallenging NegativityTransformation Through AffirmationThe Magnificent Seven Affirmations for Your TeenPart III: Parents Partnering with Teens11. Safe-Place Parenting: Partnering So Teens Will Talk, Listen, and Change.....................203Parenting Styles for Hurting TeensPurposeful ParentingParenting from the Heart of GodParenting As to the LordIt's Not About You; It's About HimLife Coaching and ConsultingFour Basic Parenting StylesBecoming an Emotion Coach12. The Proper Care and Nurture for Hurting Teens...............................................220Handle with Special CareThe Healing Heart of the HomeBuilding a Safe PlaceLearning Parental Self-ControlThe Way of the SpiritNever Give Up Hope13. How to Pray for Your Teen...................................................................241Be in Constant Conversation with GodDon't Worry; PrayPrayers for Hurting TeensChallenges in PrayerFrom Cursing to Prayer and ThanksA Closing Prayer14. Hope for Parents of Hurting Teens...........................................................260Believe It or Not, God Is WorkingJoy in Trials, Despite the TrialsBelieving the Not Yet SeenMirror TimeDealing with Difficult Reactions and EmotionsRegretting What You Did or Did Not DoThe Ultimate DespairThere Is HopeIncrease Your Level of HappinessWays to Deal with Difficult EmotionsExpress Your Thoughts in PrivateTake Good Care of YourselfTake Good Care of Your MarriageCan Any Good Come Out of This?Becoming Useful in God's HandsNotes...........................................................................................295Additional Resources............................................................................299About the Authors...............................................................................305

Chapter One

Understanding Your Teen's World

Those who go to God Most High for safety will be protected by the Almighty. I will say to the Lord, "You are my place of safety and protection. You are my God and I trust you." -Psalm 91:1-2

[Parents] ... put on tender mercies, kindness, humility, meekness, long suffering; bearing with one another, and forgiving one another. -Colossians 3:12-13 NKJV

I (Catherine) resolved to be a lot more attentive after recently sitting in the stands at a local high school football game. On a previous occasion, when my oldest daughter was one of the homecoming princesses at her private school, my husband and I sat in the front row of the grandstand, getting the "royal court" treatment.

Not this time. We were just part of the large crowd watching a game at a new, large, public school. We had climbed into the stands incognito, finding seats right in the middle of the student body. I wanted to experience the world of these teens, to be immersed in their activities while I listened and watched closely.

Our section was filled with a typical group of teens enjoying some Friday night action. To the right was a cluster of girls wearing letterman jackets emblazed with badges. Their entire focus was on who was watching them while they exaggerated every motion and conversation in hopes of being seen. Next to them was a group of visibly awkward students trying to stay low-key, despite having taken special efforts to ensure they looked good. Other teens superficially worked the scene, trying to fit in. To the left of me was a group of teen couples engaged in quite a bit of PDA (Public Display of Affection), as were others scattered around the crowds. As I scanned through the stands, I thought about the difference between these teens' generation and those of the past. Juvenile crime is down. High school seniors drink less alcohol and smoke fewer cigarettes than in the 1970s. In fact, teens nowadays are less likely to smoke than their parents. Fathers are becoming more involved, and many teens are being nurtured and cared for. They are motivated to do well and get ahead, and they show resilience to the many challenges they face in the culture and in the home. A recent Gallup Youth Survey, for example, indicates that teens now show increased interest in helping people less fortunate and have contributed to a society that is less racist, less sexist, less polluted, and more peace loving.

HOPE FOR HURTING TEENS

While there is optimism that many of our teens are journeying to adulthood mostly unscathed, there are others who are hurting and struggling through troubled times, despite their outward appearance of doing well. And as I looked around the stands at the football game, I wondered who would go home later that night, let down the happy facade, and fall into bed in despair because they weren't "attractive" or popular or cool enough. Which ones were grieving a deep loss for which they had no words to express? How many were battling the inner turmoil of stressed lives?

My heart was filled with compassion and empathy as I realized that one in five of these outwardly happy faces were vulnerable or at risk for experiencing depression. Many were under tremendous stress, a major cause of anxiety and depression. I wondered who would be the next to start having panic attacks. Who would become yet another homicide and suicide victim simply being overweight or consumed with materialism? (Both risk factors have contributed to the sharp increase in homicide and suicide rates compared to a few decades ago.)

Teens today are growing up in a different world than we did, facing challenges at a younger age and having more severe troubles with stress, depression, and related problems. They are more readily diagnosed with psychological problems than their parents were as teens. But here is the good news: scientific research has made great strides in helping us understand and treat these problems, meaning that teens can more easily overcome, get well, and stay living well. Of course, there are no miracle cures or magic pills. Still, parents can learn practical strategies and apply biblical principles to make a difference and help their teens get better.

This book purposes to do exactly that. It's important to know that, as a parent, you are not alone. You can find hope, healing, and practical help for your teen. These pages can help you respond to your teen's struggles as you partner with her to get help, get better, and stay well. Your teen can flourish in her journey from childhood to adulthood, and you can become a safe place for her to overcome adversity.

We will begin this journey by helping you enter into your teen's world to understand what she is up against. What fears does she encounter on a daily basis? Who around her gets stressed or depressed? How does she react to this? By recognizing your teen's surroundings, your approach and perspective can impact the relationship you have with her while making you aware of problematic areas in her life. As a result, you can become a caring, safe place for her, which is absolutely crucial in this venture.

Remember, as parents, you matter more than you realize. You are the most important, influential adult in your child's life, despite the masked facades and mixed messages she may give.

TURBULENT TIMES FOR TROUBLED TEENS

I (Arch) grew up in South Africa. I remember taking my future wife, Kathleen, for dates on my bicycle when movies were only twenty-five cents. And when I (Catherine) was young, a "rubber" was just an eraser and drive-ins were a great place for a family outing. Sundays were for going to church, visiting with family and friends, and taking naps. Woolworth's served a great grilled-cheese sandwich and strawberry milk-shake at the takeout counter. The neighborhood was safe enough for kids to hang out all day. The media didn't dominate our lives by telling us how to look and what to buy. Phony "reality" shows didn't exist. In fact, I didn't even see a TV until my early teens when we moved to the United States.

Sure, we had other challenges, just as you may have had. However, with every generation come greater and greater challenges. Today, teens deal with Internet pornography and online predators. Cutting is becoming a major concern. Suicide is becoming the second greatest killer of teens. One in three girls and one in six boys will be sexually abused by the age of eighteen. The age of a teen's first drink used to be fourteen; now it is twelve.

The tumultuous journey of transitioning from childhood to adulthood has never been easy. But what this current generation of teens-and those to follow-is facing will likely be even more challenging than the past. We can already see how major issues are arising sooner in life for today's teens. Future teens will have to overcome monumental hurdles at even younger ages. Their deep pain will be different from what we felt in our high school days. Their internal struggles will complicate the carefree teen years that are supposed to be "the best time of your life."

Health professionals are seeing an increase in the rates of stress, anxiety, depression, and other related disorders such as substance abuse and suicide. There is also a rise in attention deficit and conduct disorders. Extensive empirical research by the Commission on Children at Risk found that large and growing numbers of U.S. children and adolescents are failing to flourish. In particular, more and more young people are suffering from mental illness, emotional distress, and behavioral problems. The mental health and medical communities are now considering these disorders national epidemics with serious consequences to the next generation of adults. Increasingly, the greatest threat to harming or killing our teens today is mental illness, emotional distress, and the consequent behavioral problems. During the last fifty years, depression has increased at an astonishing rate. About twenty times more people suffer from depression today than in 1955, with greater stress being the predominant cause. Within the past thirty years, the average age of depression onset has dropped from twenty-nine to between fourteen and fifteen! Depression has now become a "teenage disorder" accompanied by such other problems as anxiety, eating disorders, cutting, and substance abuse.

WHO SUFFERS?

Even the most stellar teens face difficult times that can shake up their world. A teen may have been an absolute joy when young, until suddenly, out of the blue, things don't seem quite right anymore. Others never seem to get off to a good start. They may have struggled as soon as they hit the teen years and have accumulated the effects of a secret life of pain and frustration.

It can happen to the best of them-academic achievers, star athletes, homecoming princesses, those from solid, caring Judeo- Christian homes. It can also happen to those who don't feel they fit in, who plunge into low self-esteem, who don't like who they are and become who they don't want to be. Add to this list those whose worlds are being turned upside-down by fragmentation of their family structure, by illness or a sudden loss, and who feel a deep sense of meaninglessness or disconnection. The lonely and abandoned are not exempt. It happens to those lured by peer pressure into smoking, substance use and abuse, sexual promiscuity, violence, or other dangerous, high-risk behavior.

Some are wounded; others suffer consequences of poor choices. Some are born with a genetic predisposition that puts them at risk for stress, depression, and related disorders. Those who grow up in an environment that negatively impacted their early development are especially at risk. Some are born with a vulnerable personality, learning challenge, or a lower tolerance for stress or brain chemistry that makes them vulnerable to moodiness and pessimism. Others lack close connection with a parent, causing low self-esteem or feelings of abandonment. Parent styles that are harsh, too pressured, or too lenient can also lead to teen problems.

Regardless of the cause, the epidemic of stress and depression has motivated many research scientists and helping professionals to look for explanations and solutions. The good news is that we are making progress in our understanding of teen depression. And it is this good news that motivates us to write this book. Teenagers can be helped through their difficult times.

FINDING HOPE AND PRACTICAL HELP

The parents of stressed and depressed teens share a similar experience: they all feel frustrated and overwhelmed, and they are desperately looking for guidance. They have questions they need answered: What is normal for a teen? What is wrong with my teen? How do I parent a hurting teen? Never mind my teenager, how do I get through this myself? Parents realize that unless they are able to successfully survive the trials of their troubled teen, their teen won't survive either!

You and your family might be in such a crisis. It may be why you picked up this book. The world around and beneath you has been shaken like an earthquake, and the effects have been disastrous to your lives, leaving you in what a tsunami survivor described as "the land of walking wounded." Teens can easily crumble in the face of a sudden emotional tsunami, where they are overtaken by giant waves of unexpected turmoil. They can easily be swept off their feet.

Our desire in writing this book is to help you recognize when this is happening and develop a plan to intervene. We wrote this book out of the heart and experience of many strained parents, from our own experience, and based on the practical, proven interventions available in the mental health world. We pray this book offers hope to all your family while providing you with a practical resource guide to:

Inspire you to turn your heart toward your teen, to listen with renewed love, understanding, and perspective. In helping your teen through the turbulent journey into adulthood, you must enter into her world, discovering her need as you partner with her to grow, heal, and flourish.

Equip you to be aware of signs, symptoms, and triggers of stress and depression. It's crucial for you to know how to respond to your teen's struggles and pain, and how to get help. You can learn how to help her recover from stress and overcome depression practically on a daily basis, while also creating a safe place for her to get well and stay well.

Encourage you along the way. Parenting a hurting, stressed, anxious, or depressed teen can be extremely stressful, tiring, and emotionally exhausting.

In the process, we pray that hope will be ignited so you can in turn become a hope giver; that you will receive comfort to be a comforter for others; that you will persevere in prayer, counting your blessings and refusing to give up; and that you will discover meaning and purpose in your struggle so you can pass on the grace and mercy God grants you.

SAFE-PLACE PARENTING FOR HURTING TEENS

As much as we try to protect our children from the dangers and influences in the world, many teens still run into trouble. The key to surviving their struggle is universal: become a shelter for your teen. That doesn't mean you should shelter him in the sense of being overprotective. Teens are crying out for a safe place of hope. You can be that place. No matter where you are in your struggle, it is never too late to provide a safe haven for your teen and make a difference.

In doing so, it is important to understand some of the fundamental truths you will encounter as you enter into your teen's world of stress and depression. For each challenge, you can become a "safe-place parent," a parent who creates a home environment and a personal relationship that is emotionally safe and who establishes the essential foundation of resiliency to help a teen overcome depression.

1. Hurting teens live in two worlds: life on the surface and life beneath the surface.

On the surface, an average high-schooler can appear carefree, game for the latest social event, and completely cool in his designer clothes. Yet for the hurting teen, this appearance is often a mask that hides internal pain and fears.

Hurting teens' outward facades don't match their inner reality. On the surface they are bombarded with the challenges of school, pressures to perform, the influence and acceptance of peers, partying, drugs, drinking, sex, and family problems. Yet deep inside they may be struggling with stress, confusion, low self-image, loneliness, turmoil, insecurity, sadness, and despair.

Because they don't always feel safe turning to adults for help, they take matters into their own hands, turning to negative influences for ways of numbing, escaping, soothing, or self-medicating. Alcohol, smoking, cutting, eating disorders, pornography, sexual promiscuity, problems at school, sadness, irritability, and loss of interest in activities are all early indicators that a teen is masking a deeper issue. And they are usually the first signs that your teen may be in trouble.

Safe-place parents look beneath the surface to the heart of their teen.

Studies consistently show that an overwhelming majority of teens have friends and acquaintances that have experienced depression, drug and alcohol exploration, and sexual activity. Yet most often, teens say they wish they could discuss these issues in-depth not just with their friends but with their parents and other adults. Teens are letting out a primal scream of fear, anger, confusion, and hurt. Many have deep needs that are not being met, and your teen may be one of them. They want to be trusted, understood, and loved. They need to feel safe and secure, and they long for a life of meaning and purpose. They want to be listened to and heard, to be appreciated and valued, and to be supported in their efforts. They long for genuine connection and meaningful relationships based on real love.

To begin the process of helping your teen, you must first discover exactly what he is facing. What's really going on beneath the surface?

2. Hurting teens tend to keep secrets, longing to be understood and loved.

This can apply to everyday events, but especially for teens who experience traumas such as rape, physical abuse, or overwhelming stress. Teens tend to keep hurtful and stressful things to themselves and internalize their pain. They don't yet know what to do with their painful feelings or where to go for help, so they keep these struggles hidden. Teenagers don't always understand the reality of what is happening to them, how to make sense of their strong emotions, or how to communicate their feelings.

Deep down they wish they could just go to their parents or other adults for support, but few actually do. Most think that parents and adults in general are not available to talk to, or if they were they wouldn't really understand-and tragically, their fears about sharing with adults are often justified. Teens who are in desperate trouble truly believe that there is nowhere to turn for help.

(Continues...)

Excerpted from IS YOUR TEEN STRESSED or DEPRESSED?by Archibald D. Hart Catherine Hart Weber Copyright © 2008 by Dr. Archibald D. Hart and Dr. Catherine Hart Weber. Excerpted by permission.
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